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dc.contributor.authorScipione, Christopher N.en_US
dc.contributor.authorChang, Andrew C.en_US
dc.contributor.authorPickens, Allanen_US
dc.contributor.authorLau, Christine L.en_US
dc.contributor.authorOrringer, Mark B.en_US
dc.date.accessioned2008-01-04T15:18:47Z
dc.date.available2008-01-04T15:18:47Z
dc.date.issued2007-08en_US
dc.identifier.citationAnn Thorac Surg 2007 Aug;84(2):376-82 <http://hdl.handle.net/2027.42/57503>en_US
dc.identifier.urihttps://hdl.handle.net/2027.42/57503
dc.identifier.urihttp://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=17643603&dopt=citationen_US
dc.description.abstractBACKGROUND: Historically, obesity contraindicated an abdominal approach to the esophagogastric junction. The technique of transhiatal esophagectomy (THE) evolved without specific regard to body habitus. The dramatic increase in obese patients requiring an esophagectomy for complications of reflux disease prompted this evaluation of the impact of obesity on the outcomes of esophagectomy to determine whether profound obesity should contraindicate the transhiatal approach. METHODS: We used our Esophagectomy Database to identify 133 profoundly obese patients (body mass index [BMI] > or = 35 kg/m2) from among 2176 undergoing a THE from 1977 to 2006. This group was matched to a randomly selected, non-obese (BMI, 18.5 to 30 kg/m2) control population of 133 patients. Intraoperative, postoperative, and long-term follow-up results were compared retrospectively. RESULTS: Profoundly obese patients had significantly greater intraoperative blood loss (mean, 492.2 mL versus 361.8 mL, p = 0.001), need for partial sternotomy (18 versus 3, p = 0.001), and frequency of recurrent laryngeal nerve injury (6 versus 0, p = 0.04). The two groups did not differ significantly in the occurrence of chylothorax, wound infection, or dehiscence rate; length of hospital stay or need for intensive care unit stay; or hospital or operative mortality. Follow-up results for dysphagia, dumping, regurgitation, and overall functional score were also comparable between the two groups. CONCLUSIONS: With appropriate instrumentation, transhiatal esophagectomy in obese patients has similar morbidity and outcomes as in non-obese patients. Obesity, even when profound, does not contraindicate a transhiatal esophagectomy.en_US
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dc.publisherAnnals of Thoracic Surgeryen_US
dc.subjectObesityen_US
dc.subjectEsophagectomyen_US
dc.titleTranshiatal esophagectomy in the profoundly obese: implications and experience.en_US
dc.typeArticleen_US
dc.typeDataseten_US
dc.subject.hlbsecondlevelSurgery and Anesthesiologyen_US
dc.subject.hlbtoplevelHealth Sciencesen_US
dc.description.peerreviewedPeer Revieweden_US
dc.contributor.affiliationumSection of Thoracic Surgeryen_US
dc.contributor.affiliationumcampusAnn Arboren_US
dc.identifier.pmid17643603en_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/57503/6/Scipione 2007.pdfen_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/57503/5/Benign BMI Control.txten_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/57503/4/Benign BMI CS07.txten_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/57503/3/CA BMI Control no pt id.txten_US
dc.description.bitstreamurlhttp://deepblue.lib.umich.edu/bitstream/2027.42/57503/2/CA BMI 35 CS.txten_US
dc.owningcollnameThoracic Surgery, Section of


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